Each academic year the Rheumatology Fellowship Program matriculates three or four rheumatology fellows who will complete two years of subspecialty training. Following these two years, Fellows will have fulfilled the American Board of Medical Examiners requirements to be Board Eligible and sit for the Rheumatology Board examination. The first year of training is clinical and Fellows participate in three continuity care clinics. These clinics include the NIAMS Community Health Clinic, the NIAMS Clinical Center Arthritis Clinic, and the NIAMS Clinical Center Pediatric Rheumatology Clinic. In addition to these clinics, other patient care activities include the NIAMS inpatient ward, and the inpatient and outpatient consultative services. First year Fellows spend one month participating in an in-patient consultation rotation. All Fellows participate in core curriculum lectures that provide didactics concerning general rheumatology during the first five weeks of training. Additional teaching sessions include weekly core lectures, business meetings, clinical journal clubs, Rheumatology Grand Rounds, and a weekly translational journal club. Other core conferences include Director's Rounds, Intra-City Grand Rounds, clinical evening journal clubs and the District of Columbia Rheumatism Society meetings. Attendance is required of all trainees to NIH sponsored events to fulfill the requirements for training. During the first year, all Fellows are encouraged to discuss research activities with Faculty such that in the second year they can begin a mentored research activity. During the second year of Fellowship, ACGME guidelines mandate a continuity care clinic and didactic activities. This leaves approximately 80% protected time for the Fellow to gain a meaningful research exposure. The research is encouraged to be either basic bench science or clinical research. Recent examples of research projects include the study of heritary forms of inclusion body myositis, the study of inflammatory bowel disease is a novel transgenic mouse, and the examination of immunoglobulin gene regulation. The Clinical Fellowship program is vital to clinical research at the Clinical Center because all Fellows provide care for patients that are enrolled in the following protocols: 03-AR-0298 A Pilot Study with the IL-1 Receptor Antagonist Anakinra or Kineret in Patients with Neonatal Onset Multisystem Inflammatory Disease (NOMID/CINCA Syndrome) 11-AR-0241 A Pilot Study of Anakinra in Behcet's Disease (BD) 12-AR-8001 Compassionate Use Treatment Protocol 14V-MC-JAGA Treatment of Autoinflammatory Syndromes Expected to Benefit from JAK 1/2 Inhibition 13-AR-0086 A Pilot Open-Label Study of Rilonacept (Arcalyst) in the Deficiency of the Interleukin-1 Receptor Antagonist (DIRA) 11-AR-0223 Studies on the Natural History and Pathogenesis of Spondyloarthritis 91-AR-0196 Studies on the Natural History and Pathogenesis of Polymyositis, Dermatomyositis, and Related Diseases 04-AR-0066 Studies of the Pathogenesis and Natural History of Systemic Lupus Erythematosus (SLE) 00-AR-0222 Studies of the Pathogenesis and Natural History of Arthritis and Related Conditions 01-AR-0227 Natural History of Rheumatic Disease in Minority Communities 03-AR-0173 Studies of the Natural History and Pathogenesis of Neonatal Onset Multisystem Inflammatory Disease (NOMID) 99-AR-0004 Molecular Basis of Primary Immunodeficiencies 94-AR-0066 Studies of the Pathogenesis and Natural History of Systemic Lupus Erythematosus (SLE) 02-AR-0131 Collection Of Blood Components Using Apheresis From Patients With Rheumatic Diseases And Healthy Volunteers 13-AR-0005 Safety and Tolerability of Omalizumab in Patients with Lupus 03-AR-0131 Genetic Determinants of Ankylosing Spondylitis Severity - Longitudinal Study 04-AR-0205 Progression of Spinal Fusion in Ankylosing Spondylitis 11-AR-0156 Bisphosphanate Users Radiographicc Characterisitics of the Hip (BURCH) 13-AR-0056 Stopping Anti-TNF Agents in Rheumatoid Arthritis (STARA) Trial